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CENTRAL CONNECTICUT DERMATOLOGY, PLLC

Company Details

Entity Name: CENTRAL CONNECTICUT DERMATOLOGY, PLLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 12 Sep 2018
Business ALEI: 1284603
Annual report due: 31 Mar 2025
NAICS code: 621999 - All Other Miscellaneous Ambulatory Health Care Services
Business address: ONE WILLOWBROOK ROAD SUITE #2, CROMWELL, CT, 06416, United States
Mailing address: ONE WILLOWBROOK ROAD SUITE #2, CROMWELL, CT, United States, 06416
ZIP code: 06416
County: Middlesex
Place of Formation: CONNECTICUT
E-Mail: strober@centralctderm.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CENTRAL CONNECTICUT DERMATOLOGY PLLC 401(K) PROFIT SHARING PLAN 2023 831886549 2024-05-03 CENTRAL CONNECTICUT DERMATOLOGY PLLC 115
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8603222222
Plan sponsor’s address 1 WILLOWBROOK ROAD, SUITE 2, CROMWELL, CT, 06416

Plan administrator’s name and address

Administrator’s EIN 811939215
Plan administrator’s name COMPASS 360 LLC
Plan administrator’s address 118 PORTSMOUTH AVE, SUITE D201, STRATHAM, NH, 03885
Administrator’s telephone number 6037789920

Signature of

Role Plan administrator
Date 2024-05-03
Name of individual signing SETH LARNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-03
Name of individual signing SETH LARNER
Valid signature Filed with authorized/valid electronic signature
CENTRAL CONNECTICUT DERMATOLOGY PLLC 401(K) PROFIT SHARING PLAN 2022 831886549 2023-04-11 CENTRAL CONNECTICUT DERMATOLOGY PLLC 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8603222222
Plan sponsor’s address 1 WILLOWBROOK ROAD, SUITE 2, CROMWELL, CT, 06416

Signature of

Role Plan administrator
Date 2023-04-11
Name of individual signing SETH LARNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-04-11
Name of individual signing SETH LARNER
Valid signature Filed with authorized/valid electronic signature
CENTRAL CONNECTICUT DERMATOLOGY PLLC 401(K) PROFIT SHARING PLAN 2021 831886549 2022-09-07 CENTRAL CONNECTICUT DERMATOLOGY PLLC 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621399
Sponsor’s telephone number 8603222222
Plan sponsor’s address 1 WILLOWBROOK ROAD, SUITE 2, CROMWELL, CT, 06416

Plan administrator’s name and address

Administrator’s EIN 811939215
Plan administrator’s name COMPASS 360
Plan administrator’s address 118 PORTSMOUTH AVENUE, SUITE D201, STRATHAM, NH, 03885
Administrator’s telephone number 6037789920

Signature of

Role Plan administrator
Date 2022-09-07
Name of individual signing SETH LARNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-07
Name of individual signing SETH LARNER
Valid signature Filed with authorized/valid electronic signature
CENTRAL CONNECTICUT DERMATOLOGY PLLC 401(K) PROFIT SHARING PLAN 2020 831886549 2021-07-27 CENTRAL CONNECTICUT DERMATOLOGY PLLC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8603222222
Plan sponsor’s address 1 WILLOWBROOK ROAD, SUITE 2, CROMWELL, CT, 06416

Plan administrator’s name and address

Administrator’s EIN 811939215
Plan administrator’s name COMPASS 360
Plan administrator’s address 118 PORTSMOUTH AVENUE, SUITE A2, STRATHAM, NH, 03885
Administrator’s telephone number 6037789920
CENTRAL CONNECTICUT DERMATOLOGY PLLC 401(K) PROFIT SHARING PLAN 2019 831886549 2020-09-29 CENTRAL CONNECTICUT DERMATOLOGY PLLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8603222222
Plan sponsor’s address 1 WILLOWBROOK ROAD, SUITE 2, CROMWELL, CT, 06416

Plan administrator’s name and address

Administrator’s EIN 811939215
Plan administrator’s name COMPASS 360
Plan administrator’s address 118 PORTSMOUTH AVENUE, SUITE A2, STRATHAM, NH, 03885
Administrator’s telephone number 6037789920

Agent

Name Role
MCR&P SERVICE CORPORATION Agent

Officer

Name Role Business address Residence address
BRUCE E. STROBER M.D., PH.D Officer 7 GARNET HILL LANE, AVON, CT, 06001, United States 7 GARNET HILL LANE, AVON, CT, 06001, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CLAB.0001042 Clinical Laboratory ACTIVE CURRENT 2021-07-23 2023-10-01 2025-09-30
CLAB.0001025 Clinical Laboratory ACTIVE CURRENT 2020-09-04 2024-10-01 2026-09-30
CLAB.0000989 Clinical Laboratory ACTIVE CURRENT 2019-09-03 2023-07-01 2025-06-30
CLAB.0000983 Clinical Laboratory ACTIVE CURRENT 2019-06-28 2023-07-01 2025-06-30

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012071833 2024-01-18 No data Annual Report Annual Report No data
BF-0011228667 2023-01-15 No data Annual Report Annual Report No data
BF-0010206425 2022-02-03 No data Annual Report Annual Report 2022
0007104472 2021-02-02 No data Annual Report Annual Report 2021
0006785433 2020-02-26 No data Annual Report Annual Report 2020
0006556081 2019-05-13 No data Annual Report Annual Report 2019
0006354481 2019-02-01 2019-02-01 Change of Business Address Business Address Change No data
0006245528 2018-09-12 2018-09-12 Business Formation Certificate of Organization No data

Date of last update: 13 Jan 2025

Sources: Connecticut's Official State Website